title: Propranolol is more effective than pulsed dye laser and cryosurgery for infantile hemangiomas.
abstract: Propranolol hydrochloride is a nonselective β-blocker that is used for the treatment of hypertension, arrhythmia, and angina pectoris. In Japan, it was recently approved for the treatment of childhood arrhythmia. It has been observed to produce drastic involution of infantile hemangiomas. The aim of this prospective study was to examine propranolol's superiority to classical therapy with pulsed dye laser and/or cryosurgery in treating proliferating infantile hemangiomas. Fifteen patients between the ages of 1 and 4 months with proliferating infantile hemangiomas received grinded propranolol tablets 2 mg/kg per day divided in three doses. Twelve patients with proliferating infantile hemangiomas receiving pulsed dye laser and/or cryosurgery were enrolled as controls. Baseline electrocardiogram, echocardiogram, and chest x-ray were performed. Monitoring of heart rate, blood pressure, and blood glucose was performed every 2 weeks. Efficacy was assessed by performing blinded volume measurements and taking photographs at every visit. Propranolol induced significantly earlier involution and redness reduction of infantile hemangiomas, compared to pulsed dye laser and cryosurgery. Adverse effects such as hypoglycemia, hypotension, or bradycardia did not occur.
  
  
  CONCLUSIONS
  The dramatic response of infantile hemangiomas to propranolol and few side effects suggest that early treatment of infantile hemangiomas could result in decreased disfigurement. Propranolol should be considered as a first-line treatment of infantile hemangiomas.
authors.affiliation: Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan, kagamis-tky@umin.ac.jp.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kagami
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kuwano
authors.forename: Sayaka
authors.initials: S
authors.lastname: Shibata
authors.forename: Yuta
authors.initials: Y
authors.lastname: Uwajima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yamada
authors.forename: Akie
authors.initials: A
authors.lastname: Miyamoto
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyagawa
authors.forename: Mayuko
authors.initials: M
authors.lastname: Araki
authors.forename: Kohji
authors.initials: K
authors.lastname: Takahashi
authors.forename: Sayako
authors.initials: S
authors.lastname: Isomura
authors.forename: Naohiko
authors.initials: N
authors.lastname: Aozasa
authors.forename: Yuri
authors.initials: Y
authors.lastname: Masui
authors.forename: Mizuho
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Ryo
authors.initials: R
authors.lastname: Inuzuka
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Katori
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sato
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D003452:Cryosurgery; D004334:Drug Administration Schedule; D005260:Female; D006391:Hemangioma / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007223:Infant; D054025:Lasers, Dye / Q000627:therapeutic use*; D008297:Male; D011433:Propranolol / Q000627:therapeutic use*; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol